Billing and Coding: MolDX: Next-Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for MolDX: Next Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies L38123. Relevant Article: Billing and Coding: MolDX: Testing of Multiple Genes A58120: To report a Next Generation Sequencing Lab-Developed Tests for Myeloid Malignancies and Suspected Myeloid Malignancies service, please submit the following claim information: Select the appropriate CPT ® code Enter 1 unit of service (UOS) Enter the appropriate DEX Z-Code ® identifier adjacent to the CPT ® code in the comment/narrative field for the following Part B claim field/types: Loop 2400 or SV101-7 for the 5010A1 837P Item 19 for paper claim Enter the appropriate DEX Z-Code ® identifier adjacent to the CPT ® code in the comment/narrative field for the following Part A claim field/types: Line SV202-7 for 837I electronic claim Block 80 for the UB04 claim form Select the appropriate ICD-10-CM code To submit a claim for ABL1 Kinase Domain Mutation Analysis by NGS for the detection of acquired imatinib tyrosine kinase inhibitor resistance, use CPT ® code and one (1) UOS with the assigned DEX Z-Code. See also Group 2 below. NOTE: When entering the DEX Z-Code ® on the SV101-7 documentation field for Part B claims please do not add additional characters and/or information on the line. Specific tests that have been evaluated for compliance with coverage criteria set in policy (and are thus covered or not covered) can be found in the DEX® registry located at www.dexzcodes.com .